Multiple low-dose dexamethasone further improves clinical outcomes following total hip arthroplasty

Total hip arthroplasty (THA) is the most advanced osteoarthritis and other hip diseases. Till now, none of the studies recommended dexamethasone in total hip arthroplasty (THA). Therefore in the present study, the author assessed the 3-dose dexamethasone regimen and showed significant relieved from postoperative pain, ameliorate postoperative nausea, provide additional inflammatory control, enhance mobility, and shorten LOS following THA.  

The prescribed dose regimen of Dexamethasone during the total hip arthroplasty (THA) is still under debate. The study intended to estimate the impacts of various low-dose Dexamethasone on clinical outcomes following THA.

A total of 210 patients went through THA categorized into three groups; group A (3 doses of normal saline), group B (1 dose of normal saline) and group C (3 doses of intravenous Dexamethasone). Nausea and visual analog scale (VAS) score were taken as primary outcomes. The study also led to a comparison between the rate of postoperative vomiting and nausea, C-reactive protein (CRP) level, length of stay (LOS), a range of motion, use of analgesic and antiemetic rescue, and associated complications.

The group B and C showed considerably reduced VAS scores than group A on the first postoperative day. On the next day, only group C exhibited lower VAS scores. The patients of group C exhibited a reduced number of postoperative vomiting and nausea, lessened antiemetic rescue and analgesic use. The lowest levels of CRP and LOS found in group C following by group B and A. Whereas the range of motion was higher in Group C. No group presented any complication.

The 3-dose Dexamethasone regimen can further diminish postoperative pain and LOS, provide added inflammatory control, improve mobility and postoperative nausea following THA.